i) WORLD HEALTH ORGANIZATION A46/30 26 April 1993 ORGANISATION MONDIALE DE LA SANTE FORTY-SIXTH WORLD HEALTH ASSEMBLY Provisional agenda item 33 HEALTH AND ENVIRONMENTAL EFFECTS OF NUCLEAR WEAPONS Report by the Director-General Since 1981 WHO has been studying and reporting on the effects of nuclear war on health and health services. Although the likelihood of an all-out nuclear war with catastrophic consequences for humanity has greatly diminished, nuclear weapons are still present and being produced; therefore the potential danger of the consequences of their use has not yet been eliminated. Also, concern is widespread about health and environmental risks associated with accidental releases of radioactivity during nuclear weapons production, decommissioning of nuclear facilities and dismantling of nuclear warheads, in addition to the health and environmental hazards posed by nuclear tests. At the request of some Member States the item, "Health and environmental effects of nuclear weapons" has been included on the provisional agenda of the Forty-sixth World Health Assembly. This report provides information on the subject and refers to earlier related work of WHO. The members of the management group appointed by the Director-General to follow up resolution WHA36.28 were consulted in the preparation of this report. CONTENTS I. INTRODUCTION 2 II. REVIEW OF WHO ACTIVITIES, 1981 TO 1991 2 III. CURRENT SITUATION 3 IV. HEALTH EFFECTS OF NUCLEAR WEAPONS Effects of actual use 3 Health risks of nuclear weapons production and disposal 4 V. HEALTH-RELATED ENVIRONMENTAL EFFECTS OF NUCLEAR WEAPONS Effects of actual use 5 Risks of nuclear weapons production and disposal 5 VI. THE SOCIOECONOMIC EFFECTS OF NUCLEAR WEAPONS 6 VII. CONCLUSIONS 7 A46/29 page 2 I. INTRODUCTION 1. WHO and its Member States have for many years expressed deep concern over the disastrous consequences of nuclear conflict for health. From previous WHO reports on the effects of nuclear war on health and health services, published in 1984 (1) and 1987 (2), and from numerous other investigations, it is evident that besides the catastrophic effects in terms of deaths, casualties and material damage, the use of nuclear weapons will cause human suffering and environmental disturbance on an unprecedented scale. 2. The threat of a global catastrophe is now fortunately remote. The nuclear arms race among the main nuclear powers is over and a major nuclear conflict is unlikely in the foreseeable future. Nuclear weapons, however, still exist in large numbers and their spread among more countries remains a cause for concern. Continuing apprehension about harmful effects on health is thus not unfounded. 3. At the request of several Member States, the item "Health and environmental effects of nuclear weapons" has been included on the provisional agenda of the Forty-sixth World Health Assembly.1 4. This report briefly reviews previous WHO work on the health consequences of nuclear war and concentrates on current information about the effects of nuclear weapons on health, and related environmental problems. II. REVIEW OF WHO ACTIVITIES, 1981 TO 1991 5. In 1981 the Thirty-fourth World Health Assembly, by resolution WHA34.38, initiated a WHO project entitled "The effects of nuclear war on health and health services", with the aim of studying the contribution that WHO could make to the implementation of United Nations resolutions on strengthening peace, détente and disarmament and preventing thermonuclear conflict. In response to the Health Assembly resolution an International Committee of Experts in Medical Sciences and Public Health was established to carry out the project. 6. After extensive study and consultations the Committee prepared a report which was presented to the Health Assembly in 1983. It was endorsed and published in 1984 (1). This initial report reviewed the then available knowledge on the possible effects of a nuclear war. It concentrated strictly on the scientific aspects of the problem, such as the physical characteristics of nuclear explosions and their effect on health，management of casualties, and short- and long-term effects of a nuclear war on health and health services. 7. The Committee's main conclusion was that, in view of the disastrous consequences of a nuclear conflict on human health and welfare, "the only approach to the treatment of the health effects of nuclear explosions is primary prevention of such explosions, that is the prevention of atomic war" (1). 8. In 1983 the Health Assembly by resolution WHA36.28 endorsed the conclusions of the Committee, requested the Director-General to transmit the report to the Secretary-General of the United Nations, and recommended that WHO "in cooperation with other United Nations agencies, continue the work of collecting, analysing and regularly publishing accounts of activities and further studies on the effects of nuclear war on health and health services 9. In implementation of this resolution, the Director-General established the WHO Management Group on the Follow-up of Resolution WHA36.28. The Group continued the work of the Committee. The findings of new research strengthened the original conclusions presented in 1983. They made clear the fact that health services could not alleviate the situation caused by the explosion of nuclear weapons and the only approach to treatment of health effects of nuclear warfare was the prevention of nuclear war. 10. The Group's report constituted WHO's major contribution to the International Year of Peace (1986). The Fortieth Health Assembly endorsed the report by resolution WHA40.24 and decided that investigation of other health aspects of the effects of nuclear war that are not reflected in the report should be continued in 1 See document EB91/1993/REC/2, pp. 247-249. A46/29 page 2 collaboration with interested United Nations bodies and other international organizations. The report was published in 1987 (2) and has been translated into many languages. 11. WHO, the United Nations and other interested organizations continued to review the situation and collate all new scientific findings. The Management Group noted in its meetings that the increased radiation risk per unit of dose resulted partly from a new system of dosimetry; a United Nations report reviewed, inter alia’ the health aspects of nuclear war in the light of the changing political climate (3). 12. In 1991, the Management Group reported on its activities since 1981 (4). It noted that with the positive changes in the world situation it was the peacetime uses of atomic energy that had become the greater cause for concern. Nuclear weapons were, however, still being produced and stockpiled; therefore the potential danger of the consequences of their use had not yet been eliminated. Developments should be monitored. III. CURRENT SITUATION 13. The nuclear arms race between major nuclear powers has subsided and a nuclear war between them has become unlikely. Remarkable progress has been achieved in arms limitation, including agreements by the two major nuclear powers to withdraw and destroy most of their tactical weapons and drastically to reduce their strategic nuclear arsenals. Also more countries have acceded to the Treaty on the Non-Proliferation of Nuclear Weapons. 14. On the other hand, some problems remain and new ones are arising. First, a large number of nuclear weapons are still in existence and their production worldwide has not ceased altogether. Secondly, nuclear weapons are now located on the territories of more countries than before. The possibility of clandestine production of nuclear weapons in certain countries has made proliferation of great concern to world security. Thirdly, there is the problem of the dismantling and disposal of nuclear weapons and their production facilities, both of which could pose risks to the health and safety of workers, the general population and the environment. The disposal of nuclear weapons and decommissioning of production plants undoubtedly increases the need for more radioactive-waste disposal facilities and better management. Fourthly, problems are exacerbated by the fact that the number of unemployed nuclear weaponry experts is growing, which may lead to undesirable dissemination of this expertise. IV. HEALTH EFFECTS OF NUCLEAR WEAPONS Effects of actual use 15. A single thermonuclear weapon can have the destructive power of a million times the largest conventional weapon. The detonation of a nuclear weapon produces a blast wave, a thermal wave, instantaneous radiation, radioactive fall-out and an electromagnetic pulse. If a number of powerful weapons are used at the same time, global environmental disturbance and climatic changes may take place (2). 16. Most of the information concerning the health and environmental impacts of nuclear weapons comes from the two bombings that took place in 1945, the consequences of which have been and are being continually studied. In addition, other investigations are under way, based on analysis of nuclear tests, mathematical models of various scenarios, and other scientific information. 17. Immediate effects. The detonation produces three major sources of death and injury: the blast, the heat wave and instantaneous radiation. In addition, an immediate source of destruction is the electromagnetic pulse which leads to the impairment of electronic devices, including those needed for health services. Initially, the release of radioactive substances and human exposure to them would play a secondary role in terms of the health effects produced. 18. Other immediate effects include death and injury caused by overpressure，the destruction and collapse of buildings and structures, and heat and fire. Exposure to instantaneous radiation (gamma rays and neutrons) produces radiation syndrome with sickness and, possibly, death. At relatively low doses, it impairs bone marrow. At higher doses, damage occurs to the gastrointestinal tract, and at very high doses injury to the brain (2). A46/29 page 2 19. The destruction and impairment of health services would greatly impede efforts to treat the victims. Among those killed and injured would be a large number of physicians, nurses and other health workers.